Trends in the Use of Non-prescription Medications for Intentional Self-poisoning: A Review of Data from the United States Poison Control Centers

Background: Intentional self-poisoning increased by more than 50% in the U.S. among young people aged 10 to 24 years over the past decade. Among the most common medications identified in these suicide attempts are non-prescription analgesics such as acetaminophen, ibuprofen, and aspirin. Ready availability and access coupled with unsafe storage practices further make this a persistent problem. Assessing the trends in suicide attempts with these analgesics could inform strategies for safer access and storage of these analgesics.

Objectives: To assess trends in intentional self-poisoning and suspected suicide with non-prescription analgesics from 2016 to 2021.

Methods: The National Poison Data System (NPDS) contains data from cases reported to all 55 U.S. poison control centers. The NPDS collects near real-time de-identified data on overdoses or poisonings with specific products and substances. This unique data source provides an opportunity to examine current trends in self-poisoning with non-prescription analgesics and describe age-group differences in exposure.
We conducted a descriptive analysis of trends in poisonings with four selected non-prescription, single ingredient adult formulation analgesics from NPDS data collected from 2016 to 2021. Annual case counts of all human exposures, intentional poisonings, suspected suicide attempts, major clinical effects and deaths from acetaminophen, aspirin, ibuprofen, and naproxen were extracted from NPDS, plotted over time, and compared across age groups (0-5, 6-12, 13-19, 20-29, 30-39, 40-69, 70+ years).

Results: There was substantial variability by age group; of the total 321,455 suspected suicide poisoning calls during the review period, 13—19-year-old individuals were the leading age group, constituting 50.6% (162,804) of all suspected suicide attempts by poisoning while the 70+ year old age group constituted 1.1% (3585) of all cases. Overall, ibuprofen was the leading drug (44.3%) used in suspected suicide attempts from 2016 through 2019. After 2019, acetaminophen was the leading non-prescription analgesic (45.4%) used in suicide attempts, most prominently in the 13—19-year age group. Aspirin was the least used analgesic for suicide attempts overall.

Conclusions: Suicide attempts using non-prescription analgesics is a growing problem in the teenage population. Targeted interventions around access and availability may be necessary to address the problem in this population.